Articulation Treatment The Baseline Phase Step 1 Has your client already had a recent articulation evaluation or is s/he continuing in treatment from a.
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Transcript Articulation Treatment The Baseline Phase Step 1 Has your client already had a recent articulation evaluation or is s/he continuing in treatment from a.
Articulation Treatment
The Baseline Phase
Step 1
Has your client already had a recent articulation
evaluation or is s/he continuing in treatment
from a previous quarter?
– Do you know what sounds are in error?
– Do you know what sounds are to be targeted in
treatment from given recommendations?
If NO, then go to Step 2
If YES, then go to Step 3
Step 2 – Articulation Evaluation
Conduct an evaluation using an
articulation test.
Conduct a structural-functional exam
Step 2 – Articulation Test
There are many to choose from.
Some easy to administer tests include:
– Goldman Fristoe Test of Articulation – 2
– Structured Photographic Articulation Test – II
– Arizona Articulation Proficiency Scale
Step 2 – Articulation Test
Of the errors you find on the test, choose
sounds in error or patterns that are
expected to be developed by the child’s
age and/or affect intelligibility the most.
If there are multiple sounds in error,
conduct stimulability testing first to
determine which sounds you will target for
treatment (see Step 4 – Stimulability).
Step 2 – Structural-Functional
Exam
Conduct a structural-functional exam to
rule out any issues with the structure or
function of the child’s articulators.
You will look at strength, range of motion,
and coordination of the articulators.
You will receive instruction on this.
Step 3 – Connected Speech Sample
The connected speech sample is an
important component of the baseline
probing process.
You need to conduct this and put your
findings in the assessment section of the
report.
This information is generally reported as
“percent correct.”
Step 3 – Connected Speech Sample
Usually having a conversation with a child
is sufficient for eliciting a sample with
plenty of examples of sound/s in error in
multiple word positions.
There is no set time limit to the connected
speech sample – the point is to obtain an
adequate sample of sounds. If you can do
that in a 3 minute sample, great. If you
need more time, take it.
Step 3 – Connected Speech Sample
If you are trying to elicit less frequently
occurring sound/s you may need to try
some other strategies to ensure you get
an adequate sample.
Step 3 – Connected Speech Sample
Possible strategies (not inclusive):
– Using a story retelling task that is loaded with
the target sound. For example, Storytelling
Probes of Articulation Competence (SPAC) is a
pre-made resource available in the Materials
Room.
– You might also provide the child with picture
cards of words with the target sound/s in
many positions and have them create a silly
story for you.
Note: You may have to provide an example to the child of how to
create the story – use other cards.
Step 3 – Connected Speech Sample
When you are recording data from the
speech sample, you do not necessarily
have to be careful to record by word
position.
In general you record a “+” or “-” for all
opportunities for the target sound and
report it as a set.
– (e.g., /s/ was in error in 60% of opportunities in connected speech)
Step 3 – Connected Speech Sample
Caveat!
If, as you are analyzing your connected
speech sample, you are hearing a pattern
(e.g., /s/ is correct in all word final
positions, but in error in all other
positions), you must record and report
that. That is a significant finding.
Step 4 - Stimulability
Stimulability
– Is trial teaching.
– Is generally quick.
– Informs your treatment: It tells you
what sounds (if there are multiple errors) are
ready to be taught (or can be left alone to develop
on their own!)
at what response level and cuing level to start in
treatment for a single error sound.
Step 4 - Stimulability
As with all treatment, it is important to
think systematically when doing
stimulability.
Different clinicians have different ways of
approaching stimulability, but the next
several slides will describe one way to do
it.
Step 4 - Stimulability
Study your Eliciting Sounds, 2E (Secord)
focusing on the sounds you know to be in
error.
Practice administering elicitation strategies
on a peer, loved one, or child if you can.
Of course talk to your supervisor about
any “tricks of the trade” s/he might have
to share with you.
Step 4 - Stimulability
Prepare word, phrase, and sentence lists
that you will use during this trial teaching
phase.
Available to you is a document to help you
with this:
http://courses.washington.edu/sop/ArticLa
ng/Stimulability.pdf
Step 4 - Stimulability
Start at the word level.
Try different word positions using a
variety of teaching cues.
If the client is not succeeding, go down to
the syllable level.
If the client is still not succeeding, try at
the isolation level.
Step 4 - Stimulability
Of course if the child is doing well at the
word level, increase to the phrase level.
– You might do short, functional phrases (e.g.,
“a white tooth”
– You might use a “rote phrase” (e.g., I see a
___; “This is a ___”)
If the child is doing well at the phrase
level, increase to the sentence level.
Step 4 - Stimulability
On the following slide is an example of a
chart that you might want to create for
yourself to help record your data.
Step 4 - Stimulability
Step 5 – Baseline Word Probes
Once you have established your target
sounds you will administer word probes.
In general, you will probe all word
positions or contexts.
Step 5 – Baseline Word Probes
Prepare probe cards.
There are many materials available in the
Materials Room Articulation/Phonology
cabinet. Or you can create your own.
Ideally find 10 words per position/pattern
(but remember you have to have words to
use in treatment as well).
If that’s not possible, see next slide for a
strategy.
Step 5 – Baseline Word Probes
Can’t find 10 words per position?
– Try to come up with at least 3 words per
position/pattern.
– Then present cards 2 times (not back to back
though) to get a minimum of 6 opportunities.
Step 5 – Baseline Word Probes
Probe cards may be either written words or
picture cards.
Use good judgment in deciding whether it is
appropriate to use only written words. Consider
the age/educational level of the child.
Be sure to choose words that are appropriate
vocabulary (consider age and experience of child
as well as family religious/cultural beliefs).
Step 5 – Baseline Word Probes
When selecting words try to keep the
sounds in “pure positions.”
For example, some commercial materials
may use a word like “mushroom” as a
medial ‘sh’ word. But technically speaking,
in this case it is a syllable final sound and
the /r/ may make it extra difficult. This is
in contrast with “fishing” where the sound
is truly intervocalic. Try the best you can.
Step 5 – Baseline Word Probes
When presenting baseline word probes
you will instruct the child:
“I’m going to show you a card with a word
on it. I want you to say the word for me.
If you are not sure what the word is, I will
tell you and then we’ll come back to it
later to see if you remember it.”
Step 5 – Baseline Word Probes
In general we obtain 2 baseline word probe data
points.
– If the child was seen in a previous quarter (except for
Summer), you can use a data point from the previous
quarter as one of your baseline data points.
Once you have collected your baseline word
probe data you will put these word cards away –
probably until the end of the quarter.
Do NOT use your baseline word probe cards for
treatment (unless there is a special
circumstance).
Step 6 – Begin the Treatment
Phase
You now have all the information you
might need to get started with treatment.
Be sure to prepare adequate treatment
materials to begin your teaching.
Step 6 – Begin the Treatment
Phase
Begin to think about Behavioral
Objectives.
Think about what you can realistically
achieve by the end of the quarter
(consider stimulability results).
For the purposes of this clinical
experience, you probably will not be
writing your BOs at the level of
generalization. Read on…
Step 6 – Begin the Treatment
Phase
You will likely write your BOs in terms of
where in treatment you will get.
So your BOs will reflect that you will use
“treated” words, not “untreated.”
You could write a BO that reflects
performance at the conversational level, if
that is appropriate (i.e., your stimulability
testing indicated the child is ready to work
at a high level – like the sentence level).
Step 6 – Begin the Treatment
Phase
You will talk about the child’s performance
on “untreated” words in the generalization
section after each behavioral objective.
Questions?
If you have any questions about the
baseline process –
Ask your supervisor!